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Pediatric Dental
at Bridgeport
  • (503) 992-6189

  • Home
  • About Us
    • Meet Dr. Ben Kang
    • Meet Our Team
    • Office Tour
    • Testimonials
  • About Your Child
    • First Visit
    • Appointment Policy
    • Patient Forms
    • FAQs
  • Referring Doctors
  • Contact
×
  • Home
  • About Us
    • Meet Dr. Ben Kang
    • Meet Our Team
    • Office Tour
    • Testimonials
  • About Your Child
    • First Visit
    • Appointment Policy
    • Patient Forms
    • FAQs
  • Referring Doctors
  • Contact

Patient Forms & Records - Pediatric Dental at Bridgeport

For New Patients, Please Read and Print the Following Forms

Patient Registration
Medical & Dental History for Ages 0-3
Medical & Dental History for Ages 4-11
Medical & Dental History for Ages 12+
Notice of Privacy Practices
Appointment & Financial Policy

For Release of Records Requests

Record of Release Coming to Our Office
Record of Release Going From Our Office
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Pediatric Dental
at Bridgeport
  • 7455 SW Findlay Rd.
    Portland, OR 97224

  • (503) 992-6189

  • Mon - Fri: 8:00 AM - 5:00 PM
    Sat & Sun: Closed

  • Home
  • Meet Dr. Ben Kang
  • Meet Our Team
  • Office Tour
  • Testimonials
  • First Visit
  • Appointment Policy
  • Patient Forms
  • FAQs
  • Referring Doctors
  • Contact

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